The Effect of Preoperative Carbohydrate Intake on Length of Stay and Postoperative Recovery Following Laparoscopic Living Donor Nephrectomy.

Document Type

Article

Publication Date

5-1-2023

Publication Title

Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation

Keywords

oregon; pnmc; newberg

Abstract

OBJECTIVE: Enhanced Recovery After Surgery (ERAS) protocols are applied in many surgical procedures and often involve preoperative carbohydrate intake. Research surrounding the utility of ERAS in living donor nephrectomy is limited. The objective of this study was to identify whether living kidney donors who received preoperative oral carbohydrates experienced a difference in length of hospital stay (LOS), duration of time required to resume regular oral food and fluid intake, and incidence of gastrointestinal (GI) complications following laparoscopic nephrectomy compared to historical control donors who underwent preoperative fasting.

METHODS: This study was a retrospective analysis of data from adult subjects at one transplant center who underwent laparoscopic living donor nephrectomy. A total of 55 ERAS subjects who received preoperative carbohydrates and 93 historical control subjects who underwent preoperative fasting were included in the final analysis. The following variables were compared between groups: LOS, time to tolerating a regular oral diet postoperatively, time to meeting 50% of estimated fluid needs by oral intake postoperatively, and incidence of postoperative GI complications.

RESULTS: No significant differences between the ERAS and historical control groups in age, weight, body mass index, sex distribution, or estimated fluid needs were identified. Both groups consisted of predominantly female subjects. ERAS subjects experienced a shorter LOS (2.8 days versus 3.9 days, P < .001), time to tolerating a regular oral diet (36.5 hours versus 68.2 hours, P < .001), and time to meeting 50% of estimated fluid needs (25.3 hours versus 44.6 hours, P < .001) after laparoscopic nephrectomy compared to historical control subjects. No significant difference between groups in the incidence of postoperative GI complications (nausea, vomiting, or ileus) was identified.

CONCLUSION: Our findings demonstrate the advantages of ERAS in living kidney donors undergoing laparoscopic nephrectomy and support ERAS implementation within this patient population.

Clinical Institute

Kidney & Diabetes

Clinical Institute

Digestive Health

Department

Nephrology

Department

Nutrition

Department

Surgery

Link to Full Text

PSJH Full Text

Share

COinS